Menopausal symptoms after hysterectomy with opportunistic salpingectomy: a pilot study.

Background: Opportunistic salpingectomy during hysterectomy with ovarian preservation may reduce the risk of ovarian cancer, but concerns remain that adding salpingectomy to hysterectomy could affect ovarian vascularisation and subsequent function.

Objectives: To assess the feasibility of a full-scale trial to evaluate changes in menopausal symptoms based on the menopause rating scale (MRS) six months following hysterectomy, with and without opportunistic salpingectomy.

Methods: A prospective observational pilot study of premenopausal women age 40 to 55 years scheduled for hysterectomy with ovarian preservation was conducted, where participants were counselled and given the option of concomitant salpingectomy or not.

Main outcome measures: Forty-six out of 50 women chose opportunistic salpingectomy. It took 17 months to recruit 50 patients. Complete follow-up data was achieved in 43 of the 50 participants.

Results: The median MRS score remained unchanged in the opportunistic salpingectomy group at 9 [interquartile range (IQR): 3-14], both before surgery and six months afterwards (n=39). In contrast, the group of women who did not undergo opportunistic salpingectomy had a median MRS score of 11 (IQR: 3-16) preoperatively, which increased to 25 (IQR: 6-32) six months postoperatively (n=4).

Conclusions: The majority of patients in our cohort opted for opportunistic salpingectomy. However, no deterioration in menopausal symptoms was observed in this group after six months. A randomised controlled trial comparing hysterectomy with and without opportunistic salpingectomy in this patient population may not be feasible, given the strong patient preference for salpingectomy and slow recruitment.

What is new?: The development of subjective menopausal symptoms is evaluated after hysterectomy with opportunistic salpingectomy.